FHP is an acronym for Forward Head Posture, which refers to the forward placement of the head in relation to the shoulders and has been associated with neck pain and headaches.
Many studies have found that neck pain is significantly more prevalent in older adults with this type of posture.
It could also affect your jaw function if it progresses, possibly causing Temporomandibular Disorder.
A little neck anatomy lesson
Your neck has 7 vertebrae (bones). Your physiotherapist or massage therapist may refer to it as the cervical spine.
If you feel down the back of your neck, you may notice that one of the bones seems to “stick out” more than the others towards the bottom of the neck. In most humans, this is the 7th cervical vertebrae.
In individuals with a forward head posture, you would notice an exaggerated curve in their neck above this point, and you may notice that the chin pokes forward compared to a normal anatomical model.
Many people with FHP may present with skin creases on the back of their neck above this 7th cervical vertebrae.
What are the causes of forward head posture?
● Occupations that require you to sit at a desk and you have to lean forward
● You have a desk job, and you don’t have a proper desk set up
● Long-term poor posture
● Driving for long periods with poor posture/not changing positions frequently
● Long-term sleeping/reading in poor positions – reading in bed
● Previous injuries to the neck, i.e. whiplash
● Weakness or tightness of key muscles in the upper body
How does it affect function?
FHP usually affects the range of motion (ROM) of the neck and upper back, and it could also affect the ROM of the shoulder.
Your neck, thoracic spine (upper back), shoulder blades, arm bones and muscles have many interconnections. If one area is stiff, it could affect another. You can try this yourself by trying to sit in a slouched position with your chin poking forward. Now try to reach as high as you can while maintaining this position.
Now, try tucking your chin in (double chin), straightening your sitting, and reaching up again.
You should notice a difference in how high you can reach!
Are there any exercises that can help?
Some of the exercises that can help are getting your upper back and neck moving better.
Here is Sara showing us how to do a chin tuck.
Sara showing us a chin tuck exercise
We mentioned the upper back’s effect on neck positioning, so Sara showed us a thoracic rotation exercise near our Stouffville physio location.
Sara showing us a Thoracic Rotation exercise
How can a physiotherapist help?
Your physiotherapist will:
- ask you about the nature of your symptoms
- assess your posture
- assess your neck and upper back movement, strength, endurance and power
- educate you on their findings and treatment plan
- provide some manual therapy and personalized exercise prescription, they may choose to use modalities such as taping and acupuncture or dry needling
- work with you to achieve your movement goals
We provide expert physiotherapy care in Markham and our new Stouffville physiotherapy clinic. Visit us to assess and treat your pain!
References
Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis. Curr Rev Musculoskelet Med. 2019 Dec;12(4):562-577. doi: 10.1007/s12178-019-09594-y. PMID: 31773477; PMCID: PMC6
